COVID-19-associated venous thromboembolism : risk of recurrence and major bleeding
© 2023 The Author(s)..
Background: Complications under anticoagulant treatment in patients with COVID-19-associated venous thromboembolism (VTE) have not been consistently reported.
Objectives: This study aimed to compare the 90-day rates of VTE recurrences and major bleeding in patients with COVID-19-associated VTE versus those with VTE without COVID-19.
Methods: We used the RIETE registry to compare the 3-month outcomes in patients with COVID-19-associated VTE versus those with VTE without COVID-19.
Results: The study included 1,747 patients with COVID-19-associated VTE and 8,711 with VTE without COVID-19. Patients with COVID-19-associated VTE were more likely to be hospitalized at baseline and to present with pulmonary embolism. During the first 90 days, 123 patients (1.17%) developed VTE recurrences, and 266 (2.54%) experienced major bleeding. Patients with COVID-19-associated VTE had a similar rate of VTE recurrences (0.9% vs 1.2%) but a higher rate of major bleeding (4.6% vs 2.1%; P < .001) than those without COVID-19. Multivariable analysis adjusted for competing risks showed that patients with COVID-19-associated VTE had an increased risk of major bleeding (subhazard ratio, 1.395; 95% confidence interval, 1.037-1.877). The 30-day mortality after major bleeding was 26.3% in patients with COVID-19-associated VTE and 17.7% in those without COVID-19.
Conclusion: Patients with COVID-19-associated VTE had a 5-fold higher rate of major bleeding than VTE recurrences during the first 90 days of anticoagulation. In VTE patients without COVID-19, both rates were similar. These findings highlight the importance of carefully monitoring and optimizing anticoagulation in these patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:7 |
|---|---|
| Enthalten in: |
Research and practice in thrombosis and haemostasis - 7(2023), 7 vom: 28. Okt., Seite 102206 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Demelo-Rodriguez, Pablo [VerfasserIn] |
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| Links: |
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| Themen: |
Anticoagulants |
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| Anmerkungen: |
Date Revised 20.10.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.rpth.2023.102206 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363335056 |
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| 520 | |a © 2023 The Author(s). | ||
| 520 | |a Background: Complications under anticoagulant treatment in patients with COVID-19-associated venous thromboembolism (VTE) have not been consistently reported | ||
| 520 | |a Objectives: This study aimed to compare the 90-day rates of VTE recurrences and major bleeding in patients with COVID-19-associated VTE versus those with VTE without COVID-19 | ||
| 520 | |a Methods: We used the RIETE registry to compare the 3-month outcomes in patients with COVID-19-associated VTE versus those with VTE without COVID-19 | ||
| 520 | |a Results: The study included 1,747 patients with COVID-19-associated VTE and 8,711 with VTE without COVID-19. Patients with COVID-19-associated VTE were more likely to be hospitalized at baseline and to present with pulmonary embolism. During the first 90 days, 123 patients (1.17%) developed VTE recurrences, and 266 (2.54%) experienced major bleeding. Patients with COVID-19-associated VTE had a similar rate of VTE recurrences (0.9% vs 1.2%) but a higher rate of major bleeding (4.6% vs 2.1%; P < .001) than those without COVID-19. Multivariable analysis adjusted for competing risks showed that patients with COVID-19-associated VTE had an increased risk of major bleeding (subhazard ratio, 1.395; 95% confidence interval, 1.037-1.877). The 30-day mortality after major bleeding was 26.3% in patients with COVID-19-associated VTE and 17.7% in those without COVID-19 | ||
| 520 | |a Conclusion: Patients with COVID-19-associated VTE had a 5-fold higher rate of major bleeding than VTE recurrences during the first 90 days of anticoagulation. In VTE patients without COVID-19, both rates were similar. These findings highlight the importance of carefully monitoring and optimizing anticoagulation in these patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a anticoagulants | |
| 650 | 4 | |a hemorrhage | |
| 650 | 4 | |a pulmonary embolism | |
| 650 | 4 | |a venous thromboembolism | |
| 700 | 1 | |a Alonso-Beato, Rubén |e verfasserin |4 aut | |
| 700 | 1 | |a Jara-Palomares, Luis |e verfasserin |4 aut | |
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| 700 | 1 | |a Francisco, Iria |e verfasserin |4 aut | |
| 700 | 1 | |a Vidal, Gemma |e verfasserin |4 aut | |
| 700 | 1 | |a López-Ruiz, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Monreal, Manuel |e verfasserin |4 aut | |
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| 700 | 1 | |a Amorós, S |e investigator |4 oth | |
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| 700 | 1 | |a Fernández-Jiménez, B |e investigator |4 oth | |
| 700 | 1 | |a Fernández-Muixi, J |e investigator |4 oth | |
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| 700 | 1 | |a Gil-Díaz, A |e investigator |4 oth | |
| 700 | 1 | |a Gil-Hernández, A |e investigator |4 oth | |
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